目的探讨早期白内障患者单眼及双眼快速对比敏感度(qCSF)与视觉相关生活质量(QOL)的关系。
方法采用横断面研究设计，纳入2017年3—6月于中山大学中山眼科中心就诊的早期年龄相关性白内障患者46例共92眼，测量受检者最佳矫正视力状态下单眼和双眼qCSF；采用美国眼科学会视功能问卷(NEI VFQ-25)评估患者QOL并进行Rasch校准。测量患者最佳矫正视力(BCVA)(LogMAR)，根据视力分别定义视力较好眼与视力较差眼。分析视力较好眼、视力较差眼及双眼log对比敏感度曲线下面积(AULCSF)以及截止频率、1.0、1.5、3.0、6.0、12.0、18.0 c/d空间频率下的qCSF与QOL评分之间的关系。
结果受检者QOL总分为(64.13±4.76)分，与视力较好眼、视力较差眼的BCVA均呈负相关( r＝－0.386， P＝0.008； r＝－0.413， P＝0.004)；与双眼、视力较好眼和视力较差眼AULCSF均呈正相关( r＝0.531、0.524、0.711，均 P<0.001)；与双眼、视力较好眼和视力较差眼截止频率qCSF均呈正相关( r＝0.504、0.419、0.694，均 P<0.01)；与双眼、视力较好眼和视力较差眼1.5、3.0、6.0和12.0 c/d空间频率下qCSF均呈正相关(1.5 c/d： r＝0.444、0.374、0.513，均 P<0.05；3.0 c/d： r＝0.544、0.506、0.679，均 P<0.01；6.0 c/d： r＝0.545、0.530、0.710，均 P<0.01；12.0 c/d： r＝0.493、0.431、0.558，均 P<0.01)；与双眼和视力较差眼1.0、18.0 c/d空间频率下qCSF呈正相关(1.0 c/d： r＝0.296、0.292，均 P<0.05；18.0 c/d： r＝0.386、0.321，均 P<0.05)。
结论不同空间频率下qCSF更全面地反映了白内障患者视功能，早期白内障患者的QOL与视力较好眼、视力较差眼和双眼qCSF均有相关性，其中与视力较差眼qCSF相关性较强。
ObjectiveTo assess the association between visual-related quality of life (QOL) and the severity of quick contrast sensitivity function (qCSF) defects in patients with early cataract.
MethodsA cross section design was performed.Ninety-two eyes of 46 patients with early cataract were enrolled in Zhongshan Ophthalmic Center from March to June in 2017.All subjects completed the Chinese version of the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). The qCSF measurements were performed monocularly and binocularly while the patients wearing full spectacle correction spectacles.Rasch analysis was performed to obtain final NEI VFQ-25 scores.Best corrected visual acuity (BCVA)(LogMAR) was measured and the eye with the better or the worse visual acuity was defined accordingly.The correlation between the Rasch calibrated QOL composite scores and the qCSF measurements of the better eye, the worse eye and binoculus, including the area under Log contrast sensitivity function (AULCSF), qCSF under cut-off frequency and 1.0, 1.5, 3.0, 6.0, 12.0, 18.0 c/d were analyzed.This study protocol was approved by the Ethic Committee of Zhongshan Ophthalmic Center.This study complied with Declaration of Helsinki.
ResultsThe Rasch calibrated QOL composite score was 64.13±4.76.Significant negative correlations were found between composite scores of QOL and the BCVA of both the better or worse eye(the better eye: r=-0.386, P=0.008; the worse eye: r=-0.413, P=0.004). Significant positive correlations were found between the composite scores of QOL and the AULCSF of binoculus, the better and worse eye (binoculus: r=0.531, P<0.001; the better eye: r=0.524, P<0.001; the worse eye: r=0.711, P<0.001); Significant positive correlations were found between the composite scores of QOL and the qCSF under cut-off of binoculus, the better and worse eye (binoculus: r=0.504; the better eye: r=0.419; the worse eye: r=0.694, P<0.01). The composite scores of QOL was positively correlated with the qCSF under 1.5, 3.0, 6.0, 12.0 c/d of binoculus, the better and worse eye (binoculus: r=0.444, 0.544, 0.545, 0.493; all at P<0.05; the better eye: r=0.374, 0.506, 0.530, 0.431; all at P<0.05; the worse eye: r=0.513, 0.679, 0.710, 0.558; all at P<0.05). The composite scores of QOL was positively correlated with the qCSF under 1.0, 18.0 c/d of binoculus and the worse eye (1.0 c/d: r=0.296, 0.292; both at P<0.05; 18.0 c/d: r=0.386, 0.321; both at P<0.05).
ConclusionsThe qCSF measurements can reflect visual function of patients with early cataract at different spatial frequencies.The qCSF measurements of binoculus, the better eye and the worse eye show significant correlations with the composite scores of QOL.The QOL of early cataract patients shows a strong dependency on the worse eye.
邓斯元,陈志鹏,封檑,等. 早期白内障患者单眼及双眼对比敏感度与视觉相关生活质量的关系[J]. 中华实验眼科杂志,2020,38(03)：204-210.
DOI:10.3760/cma.j.issn.2095-0160.2020.03.008版权归中华医学会所有。
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